Dietitians Dish: To be or not to be on a gluten-free diet

July 1, 2014 at 2:01 a.m.

Iustina Iznaola

It's not uncommon in today's supermarket at least one full aisle of gluten-free food items. More and more consumers believe adopting a gluten-free diet provides more benefits to one's health, and therefore, they are willing to purchase these foods despite price.

Unless diagnosed with celiac disease or non-celiac gluten sensitivity, there is no need to eliminate gluten from the diet. Gluten refers to small fractions of proteins found in wheat, rye and barley. These proteins are not completely digested by the gastrointestinal enzymes and may reach the small intestine intact. In a healthy intestine, they are harmless, but in individuals with gluten intolerance and sensitivity, it can trigger intestinal inflammation and symptoms such as abdominal pain, chronic diarrhea, constipation, chronic fatigue, joint pain, delayed growth, infertility, anemia and bone disease.

Celiac disease is a genetic disorder characterized by an autoimmune response and inability to digest gluten, causing damage to the lining of small intestine. Some people do not have the genetic disorder but still have high sensitivity to gluten. Those who are suspected to have celiac disease or gluten sensitivity undergo a combination of clinical and laboratory evaluations to confirm the diagnosis. Unless advised by the doctor to eliminate gluten from the diet, there is no need to do so.

Unfortunately, gluten-free foods are promoted to the general population as aids for weight loss or healthier than foods containing gluten. However, there is no scientific evidence to support such claims. Gluten itself does not offer nutritional benefits, and foods that contain gluten are rich in iron, magnesium, vitamin B and fiber, which are essential for good health.

Gluten-free foods are typically low in these nutrients, and only few manufactured gluten-free products are enriched or fortified. Therefore, individuals with celiac disease are required to take supplements to treat and prevent nutritional deficiencies. In addition, many processed gluten-free foods are higher in calories, fat and sugar to compensate for the lack of flavor and texture provided by the gluten.

Individuals with celiac disease or gluten sensitivity are recommended to follow a Greek-Mediterranean dietary pattern, which is high in fruits and vegetables, olive oil and nuts but low in cereal products. Some of the foods they must eliminate from their diet include baked foods, wheat, rye and barley, oats, pasta and noodles. Many processed meats, thickened soups, frozen meals and snacks are made with ingredients derived from gluten-containing grains. It is highly recommended to read the food label because manufacturers clearly state when their products contain allergens such as gluten.

On the other hand, healthy individuals who seek to achieve weight loss by following a gluten-free diet may not necessarily be successful. Consumption of large amounts of pasta, breads and baked products - not gluten by itself - cause weight gain. There is no scientific consensus that solely following a gluten-free diet will promote weight loss.

However, it is agreed among dietitians, doctors and the scientific community that a daily diet including a variety of fruits, vegetables, whole grains and lean protein is likely to promote long-term weight loss.

For people without celiac disease, lifelong portion control, variety and balance, not consumption of gluten-free foods, are necessary to achieve and maintain a healthy weight.

Iustina Iznaola is a registered dietitian at DeTar Hospital. Send questions or comments to dietitians@vicad.com.